Higher Age Predicts Adverse Outcome and Readmission after Coronary Artery Bypass Grafting

Abstract

The present prospective clinical study was carried out to investigate the effect of age on mortality, morbidity, and readmission rates after coronary artery bypass grafting (CABG). Data on 1131 consecutive CABG patients were collected in a surgical center and in all 18 secondary referral hospitals up to 3 months after discharge. Analysis was based on three age groups: 64 years or less (510 patients), 65 to 74 years (448 patients), and 75 years or more (173 patients). Thirty-day mortality rates were 1.6% for the youngest, 5.4% for the middle age group, and 6.9% for the oldest. Major complications occurred in 10.8%, 21.2%, and 24.9% of these patients, respectively. Higher age was associated with more readmissions to health care facilities: The oldest patients had a rate twice as high as those in the youngest group (34.5% vs. 18.6%). Atrial fibrillation (15.4%), chest pain (10.6%), and congestive heart failure (8.5%) were the most common reasons for readmission. In conclusion, elderly patients, who are often suboptimal candidates for CABG, have higher 30-day mortality, higher morbidity, longer length of stay in health care facilities, and an increased risk of readmission within 3 months after CABG; age was an independent predictor of 30-day mortality and postdischarge readmission. Despite the higher risk of adverse events after surgery, three out of four elderly patients recover uneventfully.

Transmurality of scar influences the effect of a hybrid-intervention with autologous bone marrow cell injection and aortocoronary bypass surgery (MNC/CABG) in patients after myocardial infarction

“…Thus, we observed 2 deaths and 4 other significant adverse events during the 24 months follow up period. This is within the range that has been reported for high risk CABG patients [18]. In no case, the complications could be attributed to MNC injection.…”

“…LV function was calculated by use of the QGS program (Quantitative gated SPECT, Cedars-Sinai Medical Center, Los Angeles, U.S.A.). 18 F-FDG-PET was performed using a whole-body scanner (CTI ECAT EXACT 921, Siemens AG, Erlangen, Germany). To improve myocardial 18 F-FDG-uptake, each patient received a solution of 60 g glucose 1 h before the administration of 18 F-FDG.…”

Perioperative myocardial infarction has negative impact on health-related quality of life following coronary artery bypass graft surgery

“…A tendency toward less marked improvement among PMI patients was also seen in the psycho-social (MCS) and especially in the physical (PCS) components of the QOL, as this group showed a significantly lower magnitude of change in their PCS scores. Patients in the PMI group were a mean 3.7 years older, and our previous studies suggest that higher age predicts adverse outcome in general and also less marked improvement in health-related QOL following the CABG operation [4,25]. The possible confounding role of age was therefore investigated using repeated measures analysis of variance with age as a covariate, but the results showed no age by change interaction for PCS and MCS scores, indicating a less steep improvement for the PMI patients.…”

Skilled Care Requirements for Elderly Patients After Coronary Artery Bypass Grafting

“…Two previous studies demonstrated that patients aged 80 and older were at higher risk for discharge to skilled nursing facilities (SNFs) after CABG, but these investigations involved a small number of patients and did not differentiate between those requiring short‐term rehabilitation and those requiring extended stays 7,8 . Additional studies have shown that older patients are at higher risk for readmission to an acute‐care hospital after CABG but did not report the extent of cross‐facility use 9,10 …”